Coalition rallies for Medicaid expansion

JACKSON – More than 200 people, including health care providers and religious leaders, rallied at the Capitol on Wednesday, demanding a vote on the expansion of Medicaid.
“People over politics, people over partisanship…,” said Mississippi Hospital Association Chief Executive Officer Sam Cameron, who left no doubt his organization supports the expansion.
“To all our elected officials I respectfully request, please, on behalf of all of us who serve those who serve others, have a debate and vote on Medicaid expansion as soon as possible.”
Interspersed among the crowd of people waving “expand Medicaid now” signs were a few placards that read “Speaker Gunn, Mississippi deserves a debate and vote on Medicaid expansion.”
Gunn and his leadership team have blocked any effort to have the issue of expanding Medicaid debated by the full House, and he said Wednesday the rally did not persuade him to change his mind. Gunn has said if the vote was taken in the full House, Medicaid expansion would be defeated so he sees no reason for a contentious debate.
The federal Patient Protection and Affordable Care Act allows states to expand Medicaid to cover those earning up to 138 percent of the federal poverty level – or about $15,000 annually for an individual or about $32,000 for a family of four.
For the first three years, starting in 2014, the federal government will pay 100 percent of the medical costs and, after that, the federal share will stair-step down to 90 percent by 2020.
Gunn, Gov. Phil Bryant and other Republican leaders say the state cannot afford the costs of expansion. They say in the early years there will be administrative costs to the states. Others say an expansion would create jobs, be a relatively minimal cost to the state and provide health care coverage to as many as 300,000 – primarily the working poor.
“We see this no differently than a $100 million loan to expand the Nissan Plant,” said Steve Casteel of Madison, a United Methodist minister and president of the Mississippi Religious Leadership Conference. “This is an investment in people.”
The Legislature is currently considering a proposal to allow Madison County to issue $100 million in bonds for a possible business expansion, presumably Nissan.
The speakers at Wednesday’s rally said the expansion would help move Mississippi from its perennial spot as nation’s most unhealthy state and would prevent health care providers, particularly hospitals, from being hit with devastating financial hardships.
Cameron said over the next 10 years the hospitals would be hit with cuts totaling $4.2 billion. Many of those cuts will be to a federal program designed to offset the costs to hospitals for providing uncompensated care. Because of the Medicaid expansion, it is presumed in the federal law that there will be far fewer instances of providers treating people with no health care coverage.
He said it is “wishful thinking” to believe the state can make the hospitals whole for the loss of federal funds.
He said without the expansion, hospitals will face major cutbacks, including a reduction in services and employees, and possible closure for some.
Cameron and others, though, said the primary reason for the expansion is to provide health insurance to allow people to receive treatment that is less costly than it is when uninsured people with no other option show up in emergency rooms where they receive costly care that often comes too late.
bobby.harrison@journalinc.com